Remote E-Referral Specialist for Care Coordination

Humana Inc; Honolulu (HI); Remote; USD 40,000 - 52,000; Full time

Job summary

Humana, Inc. is seeking an E-Referral Specialist for a remote, full-time role. You will be the initial contact point for referrals, handling data collection, documentation, and compliance to promote continuity of care.

You will monitor multiple e-referral systems, manage communications, determine eligibility, and track referral statuses. Strong English communication, typing speed, and MS Office proficiency are required. Some travel and holiday coverage may be necessary.

Qualifications

• High School Diploma or its equivalent.
• Can type 40 words per minute or more.
• Comprehend and apply principles of basic math while analyzing data and generating reports
• Proficiency with Microsoft Office applications including Word, Excel, Outlook, and Teams
• Good logical thinking and decision-making skills
• Can follow strict timelines
• Communication with all levels of management
• Can work with multiple screens/systems ensuring accuracy to detail
• Time management skills and can work in a fast-paced environment
• Must read, write and speak fluent English
• Must have good and regular attendance
• Approximate percent of time required to travel: 0%
• Experience processing incoming referrals using eReferral portals and EPIC systems
• 1 or more years customer service or other healthcare related experience; preference working in a home health environment
• Knowledge of the issues related to the delivery of home health services
• Working knowledge of Medicare enrollment and guidelines governing home health agencies
• Associates degree

Responsibilities

• Monitor multiple e-referral systems to identify new referrals and manage alerts and notifications.
• Monitor email for request to pull referrals from all applicable referral systems. Perform follow-up and manage all related communication.
• Scan documentation to determine patient eligibility for services (service area, orders, insurance, etc.)
• Monitor status of all referrals received, follow up with each throughout process, reports on status weekly.
• Communicate with branch, sales, and leadership by email or phone for status updates and referral decisions.
• Daily management of ERST log with all referrals and ROCs decisions.
• Maintain acceptable productivity level, as determined by work assignment and departmental standards.
• Comply with and follow all regulatory compliance areas, policies & procedures, and company best practices.

Skills

Typing 40 wpm

Math reasoning

Communication

Time management

Attention to detail

Fluent English

Work under deadlines

Education

High School Diploma or equivalent

Associates degree

Tools

Microsoft Office

EPIC systems

eReferral portals

Job description

Humana, Inc. is seeking an E-Referral Specialist for a remote, full-time role. You will be the initial contact point for referrals, handling data collection, documentation, and compliance to promote continuity of care.

You will monitor multiple e-referral systems, manage communications, determine eligibility, and track referral statuses. Strong English communication, typing speed, and MS Office proficiency are required. Some travel and holiday coverage may be necessary.